title: Seven-year clinical outcomes of unprotected left main coronary artery stenting with drug-eluting stent and bare-metal stent.
abstract: BACKGROUND
  The superiority of drug-eluting stents (DES) over bare-metal stents (BMS) 7 years after unprotected left main coronary artery (LMCA) stenting has not been investigated.
  
  
  RESULTS
  From 2003 to 2005, 182 patients underwent stent implantation for unprotected LMCA disease (DES, 96 patients; BMS, 86 patients; acute coronary syndrome cases excluded), and the 7-year clinical outcomes between the DES and BMS groups were compared. The incidence of cardiac death or non-fatal myocardial infarction was similar between the DES and BMS groups (11.0% vs. 13.5%, P=0.78). The incidence of target lesion revascularization (TLR) at 7 years was significantly lower in the DES group than in the BMS group (26.4% vs. 40.5%, P=0.009); the incidence from 1 to 4 years and that beyond 4 years were similar between the DES and BMS groups (8.9% vs. 7.9%, P=0.97; 10.0% vs. 8.7%, P=0.74, respectively). Among patients with bifurcation lesions, whereas the incidence of 7-year TLR was significantly lower in the DES group than the BMS group in patients undergoing single-stent procedures (15.9% vs. 48.6%, P=0.002), it was similar between the 2 groups in patients undergoing 2-stent procedures (38.5% vs. 39.3%, P=0.49).
  
  
  CONCLUSIONS
  With the exception of the 2-stent procedure, the 7-year outcomes after DES implantation for LMCA disease were superior to those after BMS implantation because of the lower TLR rate, when considering TLR during the late phase.
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kubo
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.forename: Takenobu
authors.initials: T
authors.lastname: Shimada
authors.forename: Masatomo
authors.initials: M
authors.lastname: Ozaki
authors.forename: Tahei
authors.initials: T
authors.lastname: Ichinohe
authors.forename: Haruki
authors.initials: H
authors.lastname: Eguchi
authors.forename: Koshi
authors.initials: K
authors.lastname: Miyake
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hyodo
authors.forename: Naoki
authors.initials: N
authors.lastname: Saito
authors.forename: Hideaki
authors.initials: H
authors.lastname: Otsuji
authors.forename: Suguru
authors.initials: S
authors.lastname: Otsuru
authors.forename: Daiji
authors.initials: D
authors.lastname: Hasegawa
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Shigemoto
authors.forename: Seiji
authors.initials: S
authors.lastname: Habara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fuku
authors.forename: Harumi
authors.initials: H
authors.lastname: Katoh
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Satoki
authors.initials: S
authors.lastname: Fujii
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Goto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003331:Coronary Vessels / Q000601:surgery*; D003643:Death; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies